Maheshwari Devendra, Pillai Madhavi Ramanatha, Hm Priya, Kader Mohideen Abdul, Rengappa Ramakrishnan, Pawar Neelam
Department of Glaucoma, Aravind Eye Hospital, and Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Eur J Ophthalmol. 2025 Mar;35(2):559-567. doi: 10.1177/11206721241266981. Epub 2024 Aug 2.
To compare the long-term safety and efficacy of subconjunctival injection mitomycin C(MMC) with conventional sponge applied MMC during trabeculectomy.
Retrospective analysis of 98 eyes of 90 patients who underwent trabeculectomy with Mitomycin C were divided into two groups, group 1- sponge (n = 52) and group 2- Injection(n = 46). Follow-up data were collected on day one, day 15, one month, three months, six months, one year, two years and three years. Data from baseline and follow-up visits were analyzed and compared to study the significant difference in intraocular pressure (IOP), number of antiglaucoma medications (AGM) and best corrected visual acuity (BCVA) . -value of <0.05 was considered statistically significant.
Mean preop IOP was 34.61 ± 13.3 mmHg in group one and 33.07 ± 9.6 mmHg in group two, which reduced to 11.43 ± 3.2 and 11.59 ± 3.2 mmHg at three years ( < 0.001 in both groups) with no significant difference between the groups. Mean number of preoperative AGM was 2.28 ± 0.8 and 2.42 ± 0.7 in group one and two respectively which reduced to 1.19 ± 1.1( = 0.405) and 0.88 ± 0.9( = 0.001) at three years. Complete and overall success rates (complete + qualified) were 59.3% and 78.9% in group one and 60.9% and 80.4% in group two at three years. No statistically significant difference was found in complication rates, post-operative interventions, and final visual outcome in both groups.
Subconjunctival Injection MMC was a safe and effective alternative to sponge application with comparable long term surgical outcomes.
比较小梁切除术中结膜下注射丝裂霉素C（MMC）与传统海绵应用MMC的长期安全性和有效性。
对90例行小梁切除术并使用丝裂霉素C的患者的98只眼进行回顾性分析，分为两组，第1组-海绵组（n = 52）和第2组-注射组（n = 46）。在第1天、第15天、1个月、3个月、6个月、1年、2年和3年收集随访数据。分析和比较基线和随访的数据，以研究眼压（IOP）、抗青光眼药物数量（AGM）和最佳矫正视力（BCVA）的显著差异。P值<0.05被认为具有统计学意义。
第1组术前平均眼压为34.61±13.3 mmHg，第2组为33.07±9.6 mmHg，3年后分别降至11.43±3.2和11.59±3.2 mmHg（两组均P<0.001），两组间无显著差异。第1组和第2组术前AGM的平均数量分别为2.28±0.8和2.42±0.7，3年后分别降至1.19±1.1（P = 0.405）和0.88±0.9（P = 0.001）。3年时，第1组的完全成功率和总体成功率（完全+合格）分别为59.3%和78.9%，第2组分别为60.9%和80.4%。两组在并发症发生率、术后干预和最终视力结果方面均未发现统计学上的显著差异。
结膜下注射MMC是一种安全有效的替代海绵应用的方法，长期手术效果相当。
